Can I get a knee replacement surgery while being pregnant?

[zayneinlove]

Hello everyone. I am Zayne. I had a knee replacement surgery scheduled for next month, but yesterday I found out that I am currently 3 weeks pregnant. I am concerned that if I go on with this surgery, it might affect my baby. I would like to hear some opinions about this. Should I go on with the surgery? Or should I drop it till I give birth?

The anaesthetic risk could be minimised by having a spinal, which in my hospital is standard for most knee replacements anyway.

However, pregnancy also changes your connective tissues, which could affect healing or how stable the new joint is. It puts huge physiological strain on your body, which a knee replacement also does, so the double whammy would make recovery much harder. It also changes your posture and centre of gravity, making post-op physio (which is VITAL for knee replacements) more challenging and increasing your risk of falling, which is not good for either baby or your new joint.

There are also rare but potentially devastating complications like bone cement implantation syndrome, which would be catastrophic. If it was a life saving operation, there are ways to make it as safe as possible, but for elective surgery, I imagine most surgeons will strongly recommend waiting.

Yes. You're allowed to decide that you find the risks acceptable. The woman I know of appealed to her CCG.

I had a knee replacement last year at 54 and there’s no way I’d have coped if pregnant. I’ve had several knee ops prior to and no way would they have operated if I’d been pregnant.

Just to add, recovery is brutal and the painkillers are heavy duty. There are lots of reasons why being pregnant may be problematic

I was due to have eye muscle surgery and was pregnant. It was postponed and even then after I had the baby, they did a routine pregnancy test before I went into the surgery. They don’t take ANY chances because if you lost the baby they would be at risk of you claiming the surgery caused it

They are. We prescribe all the time for pregnant or postnatal patients

A friend broke her leg (badly) while pregnant. Doctors did operate (she needed metal plates) under a spinal block, so it is possible, but this was an emergency.

i had some extremely heavy duty painkillers when I had my op. They would only give them for 24 hours after nothing else worked, and were considered a last resort because they couldn’t get my pain under control, so I’m keen to hear what painkillers you’d prescribe in those situations?

And iirc, the ones that aren't okay aren't used for certain ortho surgeries anyway, because they inhibit the inflammation process necessary for healing post surgery

They won’t touch you if you’re pregnant for various reasons but a hormone called relaxin is produced during pregnancy which relaxes ligaments

Morphine?

Morphine is actually okay to be given in pregnancy as an acute medicine under close monitoring (ideally not in 1st trimester though)

Yes.

It's all individualised to the patient/operation/weeks gestation etc. Ideally no drugs in first trimester as its the highest risk , having a GA then can potentially cause spontaneous miscarriage in early pregnancy but equally as can being v septic from appendicitis so it's all a risk benefit of what we do. Things like broken limbs will be done under regional anaesthetic

Anti inflammatories are avoided. Paracetamol is fine. Opiates are fine. We give as little as we can get away with as it'll transfer to baby in tiny quantities but given the baby doesn't yet need to breathe for itself in utero it has v little impact in reality. We try our best to do things like nerve blocks if people have to have surgery when pregnant as hugely reduces their painkiller need

I feel for her as I had similar surgery under anaesthetic! My recovery was brutal. It is harder than knee replacement but I still wouldn't want to do that while pregnant.
My mum had her appendix out while pregnant with me but that wasn't elective or planned!